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Subacute combined degeneration without nutritional anemia
M Miscusi1, L Testaverde, A Rago
1Section of Neurosurgery, Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 79, 04100 Latina, Italy. massimo.miscusi@uniroma1.it
Summary
Subacute combined degeneration (SCD) is a rare neurological complication of cobalamin deficiency. Early diagnosis is crucial, even without anemia signs, for effective treatment and neurological recovery.
Area of Science:
- Neurology
- Nutritional Neuroscience
Background:
- Subacute combined degeneration (SCD) is a neurological complication linked to cobalamin (vitamin B12) deficiency.
- It typically involves demyelination of the spinal cord's dorsal and lateral columns.
- Diagnosis and treatment can be challenging if anemia is absent.
Observation:
- A 62-year-old man with a history of gastric cancer and alcoholism presented with neurological symptoms.
- Symptoms included ataxia, gait disturbance, urinary incontinence, and limb weakness.
- The patient lacked typical clinical or laboratory indicators of nutritional anemia.
Findings:
- Subacute combined degeneration (SCD) diagnosis was confirmed via 3-Tesla MRI.
- MRI revealed intramedullary signal alterations in the posterior spinal cord columns.
- These findings occurred despite the absence of overt cobalamin deficiency signs.
Implications:
- Highlights the importance of considering SCD in patients with neurological deficits, even without anemia.
- Emphasizes the diagnostic utility of advanced MRI in subtle cobalamin deficiency cases.
- Underscores that prompt diagnosis and treatment are vital for neurological recovery in SCD.
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